In its most severe form, it can be associated with congenital heart block and hydrops fetalis but is also associated with cardiac conduction defects, structural abnormalities, cardiomyopathy and congestive heart failure . This is the most feared complication of neonatal lupus. as lupus flares and comprehensive understanding of the medicines that can be safely used in pregnancy. Fetuses should be cautiously monitored for heart and neonates for neonatal lupus. Hydroxychloroquine, azathioprine and corticosteroids can be used during pregnancy and may reduce the risk of adverse results. Similarly, appropriate therapy needs to become instituted for hypertensive diseases in pregnancy. Anticoagulant therapy may be necessary for individuals with antiphospholipid syndrome. The most common complication of lupus is definitely preterm birth which can occur in approximately one-third of the individuals [12, 13]. Risk factors for preterm delivery include improved disease activity (both medical and serologic as reflected by increasing dsDNA titers and low matches), high prednisone use (which can cause premature rupture of membranes), hypertension and thyroid disease. A recent study by Clowse et al.  also mentioned elevated serum uric acid to be associated with preterm births. This in part may CAPN2 be reflective the hypertensive diseases in pregnancy, like preeclampsia and eclampsia, which are associated with elevated uric acid. Individuals with lupus have a high rate of adverse pregnancy results including preeclampsia, pregnancy deficits and intrauterine growth retardation as compared to general populace. Preeclampsia has been noted to occur at about 2C3 occasions the IB-MECA pace in lupus individuals as compared to those without lupus [15, 16]. Risk factors for preeclampsia include lupus and lupus nephritis-specific disease markers, presence of antiphosphoslipid antibodies, thrombocytopenia and reduced complement levels in addition to additional predisposing factors like advanced maternal age, history of hypertensive disease in earlier pregnancy, preexisting hypertension, diabetes and obesity [16, 17]. Preeclampsia poses a unique medical challenge given the close resemblance between preeclampsia and lupus nephritis, both of which are characterized by deteriorating renal function, increasing proteinuria, hypertension and reduced platelet counts. Serum uric acid, which is elevated in preeclampsia, can help differentiate between the two. Kuc et al.  carried out a systematic review which evaluated 7 serum biomarkers (ADAM12, f-hCG, Inhibin A, Activin A, PP13, PIGF, PAPP-A) and Doppler ultrasound of the uterine vasculature in the 1st trimester to forecast preeclampsia. However, delivery of the baby is sometimes the only definitive solution. Antiphospholipid antibodies happen in one-fourth to one-half individuals with lupus; these rates are related in Indian populace as compared to the rest of the world [4, 5]. Notably, these antibodies can occur without coexistent lupus (main antiphospholipid syndrome) and may still present the same risk to the pregnancy. IB-MECA The presence of antiphospholipid antibodies (aPL) without antiphospholipid syndrome (APS; defined in Table?2) increases the risk of adverse pregnancy results like intrauterine growth retardation and preterm births . Antiphospholipid syndrome itself is associated with pregnancy deficits. The pathophysiology is definitely thought to be related to thrombosis in uterine vasculature as well as binding of antibodies to trophoblasts, endothelial and neuronal cells . Some authors have actually connected these antibodies to movement disorders. Table?2 Definition of antiphospholipid syndrome A. Clinical criteria:Neonatal lupus is definitely a temporary condition which continues approximately 6 to 8 8?weeks after birth. Pathologically, it is due to passively acquire autoimmunity from maternal autoantibodies that mix the placenta and hence last until the maternal autoantibodies last in fetal blood circulation [29, 30]. It is usually characterized by a red-raised rash along with hematologic and hepatic abnormalities. It is seen in about 10% of individuals who usually have positive SSA (anti-Ro) and SSB (anti-La) antibodies. In its most severe form, it can be associated with congenital heart block and hydrops fetalis but is also associated with cardiac conduction problems, structural abnormalities, cardiomyopathy and congestive heart failure . This is the most feared complication of neonatal lupus. It happens in about 2% of newborns whose mothers possess SSA or SSB antibodies. However, the recurrence rates are between 16 and 20% among those with a prior pregnancy resulting in a neonate with total heart block. Complete heart block results in fetal mortality in 20% of the instances. Among the survivors, 70% require pacemaker insertion . Conduction abnormalities can be detected as early as the second trimester of pregnancy starting at 16?weeks of IB-MECA gestation. However, there have reports of total heart block actually in the.